Introduction: Acute lower limb ischemia (ALI) is a limb- and potentially life-threatening condition which requires urgent evaluation and treatment. Contemporary data on optimal therapy and prognosis of ALI are lacking, while surgical, hybrid, and foremost endovascular techniques have rapidly evolved over the past decades. Available clinical guidelines are not based on high-level evidence and do not fully reflect day-do-day practice. Contemporary data on etiology, procedural strategies as well as patient outcomes in ALI are urgently needed to improve care and prevent limb loss. The current study was initiated by the European Vascular Research Collaborative (EVRC), established by young European vascular specialists, and aims to provide insight into contemporary treatment strategies in ALI and its clinical results within Europe. In this manuscript we report the rationale and a detailed study protocol.
Material And Methods: The proposed study is a prospective, international, multicenter, observational study on ALI (PROMOTE-ALI) (ClinicalTrials.gov - NCT05138679). Patients with ALI (Rutherford classification grade I -III) of one or both lower extremities will be included in the study. The primary endpoint of the study is amputation-free survival (AFS) at 30 d. Secondary endpoints are freedom from target limb reintervention, freedom from complications, clinical outcome of the index leg, and limb salvage and survival at 30 and 90 d after diagnosis of ALI.
Conclusions: ALI remains a challenging condition and due to the heterogeneous etiology, clinical presentation and treatment strategies, a large multicenter study on this topic is needed to gain contemporary data on clinical outcomes and prognosis, especially for modern endovascular techniques. PROMOTE-ALI is expected to provide these data and set a benchmark for future randomized controlled trials (RCTs).
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http://dx.doi.org/10.1016/j.jss.2022.09.023 | DOI Listing |
Sci Total Environ
January 2025
Wildlife Health Lab, Animal Health Diagnostic Center, College of Veterinary Medicine, Cornell University, 240 Farrier Rd, Ithaca, NY 14853, USA. Electronic address:
Waterfowl serve as indicators of ecosystem health and represent a pathway of contaminant exposure for hunters who consume them. In the northeast Atlantic Flyway, data on baseline contaminant loads in waterfowl are lacking. We assessed five species of commonly harvested (and consumed) waterfowl for mercury, polychlorinated dibenzo-p-dioxins and polychlorinated dibenzofurans, polychlorinated biphenyls (PCBs), organochlorine pesticides (OCPs), and per- and polyfluoroalkyl substances (PFAS).
View Article and Find Full Text PDFJ Hazard Mater
December 2024
Discipline of Chemistry, The University of Newcastle, University Drive, Newcastle, New South Whales 2308, Australia; School of Chemistry, Monash University, Wellington Road, Melbourne, Victoria 3800, Australia. Electronic address:
Microplastics are ubiquitous and appear to be harmful, however, the full extent to which these inflict harm has not been fully elucidated. Analysing environmental sample data is challenging, as the complexity in real data makes both automated and manual analysis either unreliable or time-consuming. To address challenges, we explored a dense feed-forward neural network (DNN) for classifying Fourier transform infrared (FTIR) spectroscopic data.
View Article and Find Full Text PDFCurr Pediatr Rep
May 2024
Coronary Artery Anomalies Program, Division of Cardiology, Texas Children's Hospital, 6651 Main Street MC-E1920, Houston, TX 77030 USA.
Purpose Of Review: We present a contemporary approach to risk assessment and management of patients with anomalous aortic origin of a coronary artery (AAOCA).
Recent Findings: Anomalous left coronary artery from the right aortic sinus (L-AAOCA) with interarterial course carries a high risk of sudden cardiac death (SCD); therefore, current guidelines recommend exercise restriction and surgical intervention. Recent data in intraseptal and juxtacommissural L-AAOCA showed inducible perfusion abnormalities, leading to consideration of surgical intervention.
J Transl Med
January 2025
Department of Anatomy & Embryology, Leiden University Medical Center, P.O. Box 9600, Postal Zone: S-1-P, 2300 RC, Leiden, The Netherlands.
Background: Prenatal development of autonomic innervation of sinus venosus-related structures might be related to atrial arrhythmias later in life. Most of the pioneering studies providing embryological background are conducted in animal models. To date, a detailed comparison with the human cardiac autonomic nervous system (cANS) is lacking.
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